Learning objectives
To learn the relevant anatomy to guide minimally invasive surgery of the anterior and central skull base
To be aware of the most important imaging findings that influence treatment options
To evaluate CT and MRI imaging protocols,
advantages and disadvantages of both techniques
Background
ANATOMY OF THE ANTERIOR SKULL BASE
The anterior skull base separates the anterior cranial fossa superiorly from the paranasal sinuses and orbits below.
The boundaries of the anterior skull base are anterolaterally the frontal bones,
inferiorly the ethmoid and frontal sinuses,
orbit and orbital canals.
Superiorly the frontal lobes and the first cranial nerve and the boundaries with the central skull base are the lesser wing of sphenoid bone and planum sphenoidale.
In the anterior skull base we have to identify different landmarks on imaging....
Findings and procedure details
CT and MRI provide detailed anatomy of the skull base.
Both are complementary techniques.
CT is an excellent modality for delineation of the bone structures and MRI provides superior soft tissue contrast it is better to evaluate the intracranial extension of the lesions.
The sagittal plane provides a good vision of the skull base to decide the best surgical approach.
It is important to be aware of the contraindications to surgery that include,
invasion of the cavernous sinuses,
optic nerves and chiasm.
ASSESSMENT OF LESION...
Conclusion
CT and MRI have a key role in the evaluation of ASB and CSB
Cross sectional imaging has an important role in the evaluation of the skull base,
it provides important information about the location and extension of the lesions to allow a better surgical planning and patient management
References
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Management considerations for malignant tumors of the skull base.
Neurosurg Clin N Am 2013; 24:1–10
2- Ivan M.E.,
Jahangiri A.,
El-Sayed I.H.,
MDb,c,
Aghi M.K.
Minimally invasive approaches to the anterior skull base.
Neurosurg Clin N Am 2013; 24:19–37
3- Choudhri AF1,
Parmar HA,
Morales RE,
Gandhi D.
Lesions of the skull base: imaging for diagnosis and treatment.
Otolaryngol Clin North Am.
2012; 45:1385-404
4- Borges A.
Imaging of the central skull base.
Neuroimaging Clin N Am.
2009; 19:669-696
5- Parmar H1,...